NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Federal Poverty Income Guidelines for 2004
[34 Pa.B. 2645] The Department of Public Welfare (Department) announces the implementation in this Commonwealth of the 2004 Federal Poverty Income Guidelines (FPIGs) which were issued by the Department of Health and Human Services and published at 69 FR 7336 on February 13, 2004.
The FPIGs are the basis for the income eligibility limits for several categories of Medicaid whose regulations are published in 55 Pa. Code (relating to public welfare) and administered by the Department. These categories include Healthy Beginnings for Pregnant Women and Qualified Children (55 Pa. Code Chapter 140, Subchapter A), Healthy Horizons for the Elderly and Disabled (55 Pa. Code Chapter 140, Subchapter B) and Extended Medical Coverage under Categorically Needy TANF-Related Categories (55 Pa. Code Chapter 140, Subchapter C).
The percentages for the Medicaid categories of Healthy Beginnings and Healthy Horizons are set forth as follows:
Persons 100% of FPIG 120% of FPIG 133% of FPIG 135% of FPIG Month Annual Month Annual Month Annual Month Annual 1 $ 776 $ 9,310 $ 931 $11,172 $1,032 $12,383 $1,048 $12,569 2 $1,041 $12,490 $1,249 $14,988 $1,385 $16,612 $1,406 $16,862 3 $1,306 $15,670 $1,567 $18,804 $1,737 $20,842 $1,763 $21,155 4 $1,571 $18,850 $1,885 $22,620 $2,090 $25,071 $2,121 $25,448 5 $1,836 $22,030 $2,203 $26,436 $2,442 $29,300 $2,479 $29,741 6 $2,101 $25,210 $2,521 $30,252 $2,795 $33,530 $2,837 $34,034 7 $2,366 $28,390 $2,839 $34,068 $3,147 $37,759 $3,194 $38,327 8 $2,631 $31,570 $3,157 $37,884 $3,499 $41,989 $3,552 $42,620 Each Additional Person $ 265 $ 3,180 $ 318 $ 3,816 $ 353 $ 4,230 $ 358 $ 4,293
Persons 185% of FPIG 200% of FPIG 235% of FPIG 250% of FPIG Month Annual Month Annual Month Annual Month Annual 1 $1,436 $17,224 $1,552 $18,620 $1,824 $21,879 $1,940 $23,275 2 $1,926 $23,107 $2,082 $24,980 $2,446 $29,352 $2,603 $31,225 3 $2,416 $28,990 $2,612 $31,340 $3,069 $36,825 4 $2,907 $34,873 $3,142 $37,700 $3,692 $44,298 5 $3,397 $40,756 $3,672 $44,060 $4,315 $51,771 6 $3,887 $46,639 $4,202 $50,420 $4,937 $59,244 7 $4,377 $52,522 $4,732 $56,780 $5,560 $66,717 8 $4,868 $58,405 $5,262 $63,140 $6,183 $74,190 Each Additional Person $ 491 $ 5,883 $ 530 $ 6,360 $ 623 $ 7,473
These percentages apply as follows:
Healthy Beginnings--
a. 185% for pregnant women and infants up to 1 year of age.
b. 133% for children 1-5 years of age.
c. 100% for children 6 years of age and older who were born after September 30, 1983.
Healthy Horizons--
a. 100% for persons eligible for the categorically needy and Medicare cost-sharing benefits.
b. 120% for persons eligible for the Specified Low-Income Medicare Beneficiaries and Medically Needy Only benefits.
c. 135% for persons eligible for the Qualifying Individuals Beneficiaries benefits.
(There are different resource limits for each of these programs.)
Additional information on the specific program is available at county assistance offices.
Effective Date
This notice shall take effect upon publication in the Pennsylvania Bulletin and apply retroactively to February 13, 2004.
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-390. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 55. PUBLIC WELFARE
PART II. PUBLIC ASSISTANCE MANUAL
Subpart C. ELIGIBILITY REQUIREMENTS
CHAPTER 140. SPECIAL MA ELIGIBILITY PROVISIONS
APPENDIX A
EXTENDED MEDICAL COVERAGE (EMC) MONTHLY INCOME LIMITS
185% OF THE 2004 FEDERAL POVERTY INCOME GUIDELINES
185% of the Federal Family Size Poverty Income Guidelines 1 $1,436 2 $1,926 3 $2,416 4 $2,907 5 $3,397 6 $3,887 7 $4,377 8 $4,868 Each Additional Person $ 491
[Pa.B. Doc. No. 04-861. Filed for public inspection May 14, 2004, 9:00 a.m.]
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